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目的:探讨腹腔镜术后联合应用米非司酮治疗子宫内膜异位症的临床疗效。方法:收集872例子宫内膜异位症患者,其中372例经单纯腹腔镜手术治疗(单纯腹腔镜组),500例术后联合米非司酮(米非司酮联合组)。观察两组临床疗效、复发和受孕情况。结果:米非司酮联合组治愈率为64.0%(320/500),总有效率为87.6%(438/500),单纯腹腔镜组治愈率为34.9%(130/372),总有效率为56.7%(211/372),差异有统计学意义(χ2=72.10,P<0.01;χ2=106.86,P<0.01);米非司酮联合组复发率为6.4%(20/314),受孕率为34.4%(64/186),单纯腹腔镜组复发率为22.2%(28/126),受孕率为11.2%(14/124),差异均有统计学意义(χ2=23.25,P<0.01;χ2=21.12,P<0.01);米非司酮联合组出现轻微恶心2例,转氨酶升高3例。结论:腹腔镜术后联合应用米非司酮治疗子宫内膜异位症能有效提高疗效,减少复发,增加受孕率,减少不良反应,值得临床推广应用。
Objective: To investigate the clinical efficacy of combined use of mifepristone in the treatment of endometriosis after laparoscopic surgery. Methods: A total of 872 patients with endometriosis were collected. Among them, 372 patients were treated with simple laparoscopic surgery (simple laparoscopic group) and 500 patients were treated with mifepristone (mifepristone combined group). The clinical efficacy, recurrence and pregnancy status were observed. Results: The cure rate of the combined group was 64.0% (320/500), the total effective rate was 87.6% (438/500), the simple laparoscopic group was 34.9% (130/372), the total effective rate was The difference was statistically significant (χ2 = 72.10, P <0.01; χ2 = 106.86, P <0.01). The recurrence rate was 6.4% (20/314) in the mifepristone group and the pregnancy rate was 56.7% (211/372) (64/186). The recurrence rate in simple laparoscopic group was 22.2% (28/126) and the conception rate was 11.2% (14/124), the differences were statistically significant (χ2 = 23.25, P <0.01; χ2 = 21.12, P <0.01). In the mifepristone group, mild nausea occurred in 2 cases and elevated aminotransferase in 3 cases. Conclusion: The combination of mifepristone and laparoscopic treatment of endometriosis can effectively improve the efficacy, reduce recurrence, increase the rate of conception and reduce adverse reactions, which is worthy of clinical application.